Department of Health and Social Care

Dental Services

Michael Fabricant: To ask the Secretary of State for Health and Social Care, if he issue guidance to dentists on  when they might be expected to return to normal working.

Yasmin Qureshi: To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that dental surgeries can reopen safely for a full range of treatments before 21 June 2021.

Jo Churchill: Dentistry has been particularly affected by the risk of COVID-19 transmission due to the number of aerosol generating procedures carried out. This has resulted in the need for an enhanced level of personal protective equipment and reduced throughput to allow for thorough cleaning and resting of rooms between patients, as set out in Public Health England’s Infection Prevention and Control guidance. The Department is working closely with NHS England and NHS Improvement and the Chief Dental Officer for England to increase levels of service, as fast as is safely possible. We have been closely monitoring what has been possible and on 29 March announced that the threshold for full National Health Service contractual payment would be raised to 60% of normal activity. We continue to explore what more can be done to increase capacity including piloting pre-appointment testing.

Dental Services: Contracts

Yasmin Qureshi: To ask the Secretary of State for Health and Social Care, whether he plans to introduce changes to the Unit of Dental Activity targets in the next financial quarter.

Jo Churchill: Contractual arrangements for the first six months of the 2021/22 financial year have been introduced by NHS England and NHS Improvement. The revised unit of dental activity threshold set at 60% is based on data that indicates practices may now have capacity to safely achieve more dental activity. Arrangements will be monitored on a monthly basis and are expected to be in place for six months in order to provide increased stability for dental practices. National Health Service commissioners have the discretion to make exceptions, for instance in cases where a dental practice has been impacted by staff being required to self-isolate.The Department will work with the British Dental Association and NHS England and NHS Improvement who will lead the next stage of dental contract reform. This will involve designing implementable proposals that address the key challenges facing the delivery of NHS dentistry and will encourage a more preventative approach to dentistry.

Dental Services: Coronavirus

Michael Fabricant: To ask the Secretary of State for Health and Social Care, whether dentists will be able to return to normal working practices in (a) Step 3 or (b) Step 4 of the national covid-19 roadmap.

Jo Churchill: We are working with NHS England and NHS Improvement to increase levels of dental activity as fast as is safely possible. Contractual arrangements for the first six months of the 2021/22 financial year have been introduced by NHS England and NHS Improvement. The revised unit of dental activity threshold set at 60% is based on data that indicates practices may now have capacity to safely achieve more dental activity. Arrangements will be monitored on a monthly basis and are expected to be in place for six months in order to provide increased stability for dental practices. National Health Service commissioners have the discretion to make exceptions, for instance in cases where a dental practice has been impacted by staff being required to self-isolate. We are working to address oral health inequalities. NHS England and NHS Improvement have provided local commissioners with a flexible commissioning toolkit to illustrate how best to use current flexibilities in commissioning to target capacity on improving access to urgent care and delivering care to high risk patient groups.

Dental Services: Standards

Justin Madders: To ask the Secretary of State for Health and Social Care, with reference to the reintroduction of targets for NHS dental practices, what recent assessment he has made of the effect of those targets on access to urgent dental care; and what discussions he has had with the British Dental Association on the reintroduction of those targets.

Jo Churchill: The Department has no current plans to assess the contractual arrangements for 2021/22. Contractual arrangements for the first six months of the 2021/22 financial year have been introduced by NHS England and NHS Improvement. The revised unit of dental activity threshold set at 60% is based on data that indicates practices may now have capacity to safely achieve more dental activity. Arrangements will be monitored on a monthly basis and are expected to be in place for six months in order to provide increased stability for dental practices. National Health Service commissioners have the discretion to make exceptions, for instance in cases where a dental practice has been impacted by staff being required to self-isolate.The Department will work with the British Dental Association and NHS England and NHS Improvement who will lead the next stage of dental contract reform. This will involve designing implementable proposals that address the key challenges facing the delivery of NHS dentistry and will encourage a more preventative approach to dentistry.

NHS: Dental Services

Stephen Morgan: To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the effect of NHS activity targets for dentistry on (a) reducing the backlog of urgent care and (b) the financial viability of dental practices.

Jo Churchill: The Department has no current plans to assess the contractual arrangements for 2021/22. Contractual arrangements for the first six months of the 2021/22 financial year have been introduced by NHS England and NHS Improvement. The revised unit of dental activity threshold set at 60% is based on data that indicates practices may now have capacity to safely achieve more dental activity. Arrangements will be monitored on a monthly basis and are expected to be in place for six months in order to provide increased stability for dental practices. National Health Service commissioners have the discretion to make exceptions, for instance in cases where a dental practice has been impacted by staff being required to self-isolate.The Department will work with the British Dental Association and NHS England and NHS Improvement who will lead the next stage of dental contract reform. This will involve designing implementable proposals that address the key challenges facing the delivery of NHS dentistry and will encourage a more preventative approach to dentistry.

Coronavirus: Vaccination

Mr Ben Bradshaw: To ask the Secretary of State for Health and Social Care, what the evidential basis was for the Government's decision to delay the second dose of the covid-19 Pfizer vaccine; and what assessment he has made of the compatibility of that policy with guidance issued by the manufacturer and the World Health Organization on that matter.

Nadhim Zahawi: The decision to extend the dosing interval to up to twelve weeks was based on advice from the Joint Committee on Vaccination and Immunisation (JCVI) and the United Kingdom’s four Chief Medical Officers (CMOs) and was designed to maximize the impact of the vaccination programme.After studying all the available data, the JCVI concluded that the first dose of either Pfizer/BioNTech or Oxford/AstraZeneca vaccine provided substantial protection from severe COVID-19 disease within two to three weeks of vaccination.  Whilst the second vaccine dose is important to sustain the protection and extend its duration, in the short term the additional impact of the second dose is likely to be modest and most of the initial protection from clinical disease is after the first dose of vaccine.The four UK CMOs agreed with the JCVI that prioritising the first doses of vaccine for as many people as possible on the priority list would protect the greatest number of at-risk people in the shortest possible time. The evidence underpinning the JCVI’s advice and the statement of the four CMOs can be found at the following links:www.gov.uk/government/publications/prioritising-the-first-covid-19-vaccine-dose-jcvi-statement/optimising-the-covid-19-vaccination-programme-for-maximum-short-term-impactwww.gov.uk/government/news/statement-from-the-uk-chief-medical-officers-on-the-prioritisation-of-first-doses-of-covid-19-vaccines This policy is compatible with guidance issued by the manufacturer. The Medicines and Healthcare products Regulatory Agency’s (MHRA’s) Information for Healthcare Professionals regarding the Pfizer vaccine states that the second dose should be given at least 21 days after the first dose. This advice is based on clinical trial data and other information submitted to the MHRA by the manufacturer.The interim guidance for use of the Pfizer Vaccine, set out by the World Health Organization on 8 January 2021, was not available to assess when the decision to extend the dose interval in the UK was made on 30 December 2020. Different organisations will come to their own view as to the vaccination approach appropriate to their respective situations, and compatibility with the advice of external organisations or institutions is not a pre-requisite for approaches taken within the Government’s vaccine deployment programme.

Coronavirus: Kidney Diseases

Dan Jarvis: To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential merits of placing patients who receive in-centre haemodialysis in priority group 1 for covid-19 vaccination.

Nadhim Zahawi: For phase one of the vaccine programme, the underlying principles at the forefront of the Joint Committee on Vaccination and Immunisation (JCVI) advice are to reduce mortality and morbidity, and to protect the National Health Service and social care systems. Having considered a number of different vaccination strategies, the robust evidence indicates that the best option for preventing mortality in the initial phase of the programme is to directly protect persons most at risk.Having identified age as being the biggest determining risk factor to increased mortality the JCVI has advised for cohort one vaccinations should be prioritised for older care home residents and staff given the high levels of severe outcomes in this cohort. This is followed by health and social care workers, then to the rest of the population aged 50 years old and above in order of age and clinical risk factors.Those undergoing haemodialysis have been prioritised in priority cohort six as defined in the Green Book Chapter 14a for those with chronic kidney disease. Further information is available at the following link:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/961287/Greenbook_chapter_14a_v7_12Feb2021.pdf

Coronavirus: Vaccination

Thangam Debbonaire: To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that parents and carers of children who are clinically extremely vulnerable are able to receive the covid-19 vaccine as soon as possible.

Nadhim Zahawi: The Joint Committee on Vaccination and Immunisation (JCVI) is the independent body made up of scientists and clinical experts who advise the Government on prioritisation of vaccines at a population level. At present, there is very limited data on vaccination in adolescents, with no data on vaccination in younger children. The JCVI advises that only those children at very high risk of exposure and serious outcomes, such as older children with severe neuro-disabilities that require residential care, should be offered vaccination as part of phase one.The Public Health England Green Book, which provides guidance for health professionals and immunisation practitioners, also sets out that children under 16 years of age, even if they are clinically extremely vulnerable (CEV), are at low risk of serious morbidity and mortality, and given the absence of safety and efficacy data on the vaccine, are not recommended for vaccination.Parents and carers of children who are CEV will be prioritised for vaccination if they are frontline health or social care workers, or if they are an unpaid carer who is in receipt of carers allowance or are the sole or primary carer for a child who is particularly vulnerable to COVID-19. All other parents and carers will be vaccinated alongside other adults of the same age, or earlier if they have an underlying health condition themselves which makes them particularly vulnerable to COVID-19.

Coronavirus: Vaccination

Mr Barry Sheerman: To ask the Secretary of State for Health and Social Care, what plans his Department has to increase the take-up rate of the covid-19 vaccination among social care staff.

Nadhim Zahawi: On 13 February we published our United Kingdom COVID-19 Vaccine Uptake Plan, which aims to improve uptake across all communities. The approach set out in the plan is underpinned by four enablers at national, regional and local level. These are: working in partnership; removing barriers to access; data and information; and conversations and engagement.There are ongoing initiatives at the national and local level to encourage vaccine uptake among the adult social care workforce. The Department is developing communications materials to encourage vaccine uptake, which are being shared with social care stakeholders to use in conversations with members of the workforce who are recognised as clinically vulnerable.More information can be found at the following link: www.gov.uk/government/publications/covid-19-vaccination-uptake-plan

Coronavirus: Vaccination

Ms Lyn Brown: To ask the Secretary of State for Health and Social Care, whether it is national policy that unused covid-19 vaccines within a batch allocated to prisoners in a prison setting may be used to vaccinate prison staff in that prison.

Nadhim Zahawi: On 11 March 2021, the Joint Committee on Vaccination and Immunisation recommended that any left-over vaccine that cannot be used on detainees should be used for prison officers. This is increasingly unlikely given the numbers of detainees now eligible for the vaccine as the programme continues. However, in cases where vaccine remains unused following an offer of vaccination to those in detained settings, NHS England and NHS Improvement have been asked to consider offering those vaccines to prison officers, in order to minimise wastage in delivery of the programme.

Coronavirus: Vaccination

Tulip Siddiq: To ask the Secretary of State for Health and Social Care, whether he has made an assessment of the potential merits of adding people with long covid to the priority list for covid-19 vaccination.

Nadhim Zahawi: Over 25 million people across the United Kingdom have now received their first dose of a COVID-19 vaccine. The Joint Committee on Vaccination and Immunisation is monitoring the emerging evidence on ‘long’ COVID-19 and will review this as part of its considerations for the immunisation programme.

Care Homes: Coronavirus

Sarah Olney: To ask the Secretary of State for Health and Social Care, if his Department will publish the proportion of care home (a) residents and (b) staff offered each covid-19 vaccine dose to date; and what proportion of (a) residents and (b) staff have refused that vaccine.

Nadhim Zahawi: Data on those who refuse the COVID-19 vaccine is not collected. NHS England and NHS Improvement publish weekly data on in England. This includes breakdowns of vaccinations by residents and staff in older adult care homes; the social care workforce; and National Health Service trust health care workers in the Electronic Staff Record. The weekly publication is available at the following link: www.england.nhs.uk/statistics/statistical-work-areas/covid-19-vaccinations/

Coronavirus: Vaccination

Jim Shannon: To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that GPs are able to identify (a) asthma and (b) ME patients for the covid-19 vaccine through their medical records.

Nadhim Zahawi: To assist general practitioners (GPs) identify patients eligible for a vaccine in each priority cohort, NHS Digital has aligned specifications for the identification of patients via their medical records with GP system suppliers. Asthma sufferers will be identified through this system and invited to make an appointment when the vaccination programme has reached their respective priority cohort. To date, chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) has not been identified as either a condition that makes an individual clinically extremely vulnerable or as a condition that would place an individual at increased clinical risk from COVID-19. GPs will therefore not specifically be identifying CFS/ME patients for COVID-19 vaccines via their medical records. It is more likely that patients with CFS/ME will be offered COVID-19 vaccines because they are eligible through other means such as their age, or they have other underlying health issues that would put them at increased clinical risk.